98.2.23-DR Sadeghi-Conference NFPA

Non‑functioning pituitary adenomas indications for pituitary surgery
and post‑surgical management

• estimated prevalence of  NFPAs is 7–41.3 cases/100,000
• the annual incidence is  0.65–2.34 cases/100,000
• NFPAs are histologically benign tumors
• increased comorbidities and excess mortality
• Careful clinical examination as well as endocrine, radiological, and ophthalmological assessment determine the best treatment strategy

symptoms related to the mass effect

• Headache :              16–70%

                                  Tumor enlargement )stretching of the diaphragm of the                                        sella with activation of pain fibers within the dura mater)

                                  frontal and occipital regions

• visual impairment * :bitemporal visual defects

)                                 mid-chiasmal compression(

                                  the frequency at diagnosis  =28 -100%

 *                               Diplopia is rare, but when present

                                  compression of the cavernous sinus

symptoms related to the mass effect

• The mechanical compression of normal pituitary cells, pituitary stalk, and portal vessels may lead to hormone deficiencies, hyperprolactinemia, and, rarely, diabetes insipidus
• The prevalence of hypopituitarism at diagnosis : 37 -85 %
• rarely present with pituitary apoplexy : endocrine emergency caused by an acute infarction           or hemorrhage in the tumor

     Common clinical features include sudden severe headache,visual loss, nausea, vomiting,               impaired consciousness , symptoms of meningeal irritation, acute endocrine dysfunction